| NPI | 1073839601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA MD449138) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.095846) |
| Enumeration Date | 2010-04-07 |
| Last Update Date | 2013-08-06 |